Rheumatic heart disease Case Study No.10

Rheumatic heart disease and mitral stenosis with superimposed infective endocarditis is the topic of this case study file no. 10. We try to discover the reason for this disease and how can we analyze it by using pathology techniques. So now we move to our main topic.

Rheumatic heart disease Case:

An 18-year-old man presents to the outpatient service with complaints of palpitations and joint pain for a year. Palpitation shows no improvement at rest. Joint pain is a fleeting type involving multiple major joints, associated with redness and swelling. Lately, for a month he has had a low fever, sometimes with chills and dyspnea when doing outdoor activities. There is no history of intravenous drug abuse.

Requirements:

1. You are required to Discuss the clinical correlation with the pathogenesis of the features.

2. What is the probable diagnosis?

3. Investigate and confirm the diagnosis?

Clinical Correlation

This young man has been suffering from palpitations for a year, which may be due to heart disease. Pansystolic murmur refers to mitral stenosis. At the same time, he suffered from temporary joint pain affecting a large, soft and swollen joint. It is a classic feature of arthralgia in RHD. The expression “rheumatism licks the joints but with all the heart” also applies to this patient. Thus, this patient developed mitral stenosis due to RHD with involvement of a large joint. A mild fever for a month with a cold is most likely due to RHD and infection with damaged mitral glands.

Probable Diagnosis

Rheumatic heart disease and mitral stenosis with superimposed infective endocarditis

Investigation:

Here is the pathology method of Investigation for the Rheumatic heart disease Case Study

  1. ECG
  2. Doppler studies i
  3. CBC (haemoglobin, counts, indices), ESR, PCV, blood smear examination. iv) Urine examination (albumin, glucose, microscopy).
  4. C-reactive proteins.
  5. ASO titres.
  6. Blood culture.
  7. Biochemical estimation: Serum cardiac markers (CK-MB2: CK-MB1 ratio, LDH-1: LDH2 ratio, cardiac troponins T and I), renal function tests (urea, creatinine, BUN), liver function tests (bilirubin, ALT, AST, alkaline phosphatase, total proteins and AG ratio), blood glucose, lipid profile.
  8. Serology for HBV, HCV, HIV.
  9. X-ray chest.
  10. Ultrasound examination of abdomen.

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